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SANJ O A Q U I N Environmental Health Department <br /> Sweet Sorghum Roasted Coffee <br /> ElSyrup ❑ (Beans/Grounds) ElChocolate Covered Nonperishable Food <br /> Fried or Baked <br /> E] Donuts and Waffles ❑ Dried Hot Chocolate ❑ Other <br /> Do not contain eggs,cream,or cream cheese <br /> If preparing jams,jellies or fruit butters,include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal <br /> Regulations http://w .accessdata.fda.uov/scripts/cdrh/cfdocs/efCFRICFRSearch_cfm?CFRPart=150 <br /> Food Descriptions: <br /> Amsted cooyies <br /> _Of <br /> EHD 16-276!29/17 CFO REG/PERMITTING FORM <br />